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# S Technologies Soil Retycli ,ate <br /> - an fest Non-Hazardous Soils 4xinifest'# 4- t <br /> Date Ship Responsible for Payment Transporte Truck# Facility# Given by TPS Load# <br /> Generator �[� le- I <br /> A14 00014 0 <br /> Gen ator s Na c and Billing Addres Gcnerator's Phonc# Gcncrator s U5 EPA ID No <br /> ULTRAMAR, INC. (209) 583-5545 <br /> 525 WEST THIRD STREET Pcr-.ontoContact <br /> TERRANCE FOX <br /> HANFORD, CA 93230 USA FAx#(209) 583-3282 cnisto 1002367bcrwirhTl'S <br /> Consultant s Naanc and Billing Address 11 Consultant s Phone# <br /> HORIZON ENVIRONMENTAL (916) 939-2170 <br /> 5011 GOLDEN FOOTHILL PARKWAY Pfmont RYtacBARKER 4 <br /> SUITE 7 <br /> FAX# CustomcrAccountNvmbcrwith TPS <br /> EL DORADO HILLS, CA 95762 USA <br /> (916) 939-2172 4HORIZO <br /> Generation Site(Transport from) (name&address) Site Phonc# BTEX <br /> BEACON STATION #1-641 (209) 583-3247 Levels <br /> 1210 EAST HAMMER LANEPersgntoContact TrH k <br /> p JERRY UNRUH Levels t <br /> FAx AVG <br /> CXT�)N, CA 95210 USA t 209) 583-3282 Levels <br /> VDesignated Facility(Transport to) (name G address) r Faenhty Phone# Facility Perrrut Numbers <br /> o <br /> TPS TECHNOLOGIES INC. (510) 235-8778 <br /> 20 RECYCLING LANE 1'crsontoContact <br /> C. Rice/D. Kuraf3hima <br /> FAX# <br /> RICHMOND, CA 94801 ,.USA (510) 231-4154 <br /> gransporter Name and Mailing Address Transporter s Phone# Transporter's US EPA 1D No <br /> LUTREL TRUCKING (805) 399-0246 <br /> 6315 SNOW ROAD Person to Contact Transporter s DOT No <br /> HERMAN <br /> BAKERSFIELD, CA 93308 FAX# CustomirLfucAWit�Iltmberwith TPS <br /> Description of Sod Moisture Content Contaminated by Approx Qty Description of Delivery Gross Welght 1 Three WWelght Het Weight <br /> Sand ❑ Organic❑ a-10% ❑ Gas ❑ <br /> Clay ❑ Other ❑ 10-20% ❑ Diesel ❑ `� <br /> 20%-over❑ Other ❑ D <br /> Sand ❑ Organic❑ 0-10% ❑ Gas ❑ x <br /> Clay ❑ Other ❑ 10-20% LJDiesel ❑ <br /> 20%-over❑ Other ❑ y <br /> Inst any exception io items listed above <br /> t � <br /> Generators and/or consultant's certification I/We certify that the soil referenced herein is taken entirely from those soils described in the Soil Data <br /> Sheet coni ed and cert ed by me/us for he Gerterahon Site shown above and nothing has been added or done to such soil that would alter it in <br /> any waymavm)cLEA <br /> Prmt or nerator ❑ Consultant U Sigi Month Day Year <br /> L Transpo ter's certification IlWe acknp6ledge receipt of the soil described above and certify that suc is being delivered in exactly the same <br /> ocondition as when received IIWe further certify that this soil is being directly transported Generation Site to the Designated Fac4lity, <br /> COL without off-loading,adding to,subtracting from or in any way delaying delivery to such sit <br /> Pint ame Si afore a Month Day Year <br /> rReq7yc1mg <br /> cies <br /> w <br /> Facility certifies the receipt of the soil covered by this manifest except as noted above <br /> �}. :i,� ype Name Signature and date <br /> s <br /> Cc <br /> Please print or type, ! <br /> TPS INVOI NG COPY <br />